tracheoarterial fistula

Q: The complication of tracheoarterial fistula after tracheostomy occurs due to erosion from the tracheal tube into? (select one) 

A) anterior wall of the trachea 
B) posterior wall of the trachea


Answer: A

More than 80% of the patients die if tracheal tube ends up forming tracheoarterial fistula. It requires immediate bedside physical tamponade of the vessel by passing a finger through the tracheostomy stoma. The above information is vital to know that the innominate artery passes anteriorly across the trachea, and tamponade should be done by pressing the finger inside the tracheal stoma anterior towards the sternum.

#procedures


References:

1.. Ridley, R. W.; Zwischenberger, J. B. (2006-08-01). "Tracheoinnominate fistula: surgical management of an iatrogenic disaster". The Journal of Laryngology & Otology. 120 (8): 676–680.  

2.. Scalise P, Prunk SR, Healy D, Votto J. The incidence of tracheoarterial fistula in patients with chronic tracheostomy tubes: a retrospective study of 544 patients in a long-term care facility. Chest 2005; 128:3906.